title: A pharmacy's journey toward the patient-centered medical home.
abstract: OBJECTIVE
  To describe the integration of a clinic pharmacy with a patient-centered medical home (PCMH).
  
  
  METHODS
  Primary care clinic in Monroe, WA, from 1981 to January 2011.
  
  
  METHODS
  Pharmacists and physicians with a previous working relationship in a family practice residency program established colocated practices in 1981. In addition to traditional pharmacy services, collaborative practice agreements were developed and clinical pharmacy services expanded over time. Reimbursement challenges for clinical pharmacy services existed in the fee-for-service environment. The acquisition of the clinic and pharmacy by Providence Health and Services created a new financial alignment with additional opportunities for collaboration.
  
  
  METHODS
  An internally funded grant established a PCMH pilot that included pharmacist participation. PCMH pharmacists and the care provider team identified areas to improve physician and clinic efficiencies and to enhance patient care.
  
  
  RESULTS
  Clinical pharmacy services expanded under the PCMH model. Pharmacist activities included value-added refill authorization services, coordinated patient visits with the PCMH pharmacist and physicians, medication therapy management, diabetes and anticoagulation services, hospital discharge medication reconciliation, and participation in the shared medical appointment.
  
  
  CONCLUSIONS
  Clinical pharmacy services are woven into the PCMH fabric of this clinic. New pharmacists will be challenged and rewarded in this evolving health care model.
authors.affiliation: Providence Regional Medical Center Everett, Monroe, WA School of Pharmacy, University of Washington, Seattle, WA, USA. steven.erickson@providence.org
authors.forename: Steven
authors.initials: S
authors.lastname: Erickson
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hambleton
mesh_terms: D003299:Cooperative Behavior; D006801:Humans; D007400:Interprofessional Relations; D054539:Medication Therapy Management / Q000458:organization & administration; D017146:Models, Organizational; D018802:Patient-Centered Care / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D010820:Physicians / Q000458:organization & administration; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role; D012051:Reimbursement Mechanisms